A path to early diagnosis of mild cognitive impairment and dementia: validity and reliability of the myMemCheck® self-administered screening tool

2020 ◽  
Vol 37 (4) ◽  
pp. 561-567
Author(s):  
William E Mansbach ◽  
Ryan A Mace ◽  
Melissa A Tanner ◽  
Steven P Simmons
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
Diagnostic Process ◽  
Validity And Reliability ◽  
Characteristic Analysis ◽  
Cross Sectional

Abstract Background Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed at home to identify older adults that would benefit from a more comprehensive cognitive evaluation. Objective Two prospective cross-sectional studies were conducted to examine the psychometric properties and clinical utility of myMemCheck®. Methods In Study 1, participants were independent living residents referred to an outpatient memory clinic (N = 59); older adults in the community and post-acute nursing home residents (N = 357) comprised Study 2. Results Psychometric analyses were performed on cognitive and psychological testing data, including myMemCheck®. myMemCheck® evidenced adequate reliability and strong construct validity. Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults at risk for MCI or dementia. myMemCheck® explained 25% of cognitive status beyond basic patient information. Conclusions myMemCheck® may help fast-track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in health care and prevent negative outcomes associated with undetected cognitive impairment.

scholarly journals A Path to Early Diagnosis of MCI and Dementia: Integrating myMemCheck Into the Primary Care Workflow

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 261-262
Author(s):  
William Mansbach ◽  
Ryan Mace ◽  
Theresa Frangiosa ◽  
Virginia Biggar ◽  
Meryl Comer ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Predictive Value ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Cognitive Status ◽  
Diagnostic Process ◽  
Characteristic Analysis ◽  
Self Assessment ◽  
Study Results

Abstract Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed in the practice setting or at home to identify older adults that would benefit from a more comprehensive cognitive evaluation for MCI and dementia. Two prospective cross-sectional studies (N = 59; N = 357) were conducted to examine the psychometric properties and clinical utility of myMemCheck®. myMemCheck® evidenced adequate reliability (test-retest, r = 0.67) and strong construct validity (η2 = 0.29, discriminating normal, MCI, dementia). Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults with MCI or dementia (sensitivity = 0.80, specificity = 0.67, positive predictive value = 0.91, negative predictive value = 0.43). myMemCheck® explained 25% of cognitive status beyond basic patient information. We provide specific suggestions for integrating myMemCheck® into practice to optimize workflow. Study results are further interpreted in the context of two national online surveys (healthcare professionals, N = 181; consumers, N = 1740). Healthcare professionals widely agreed on the need (94%) and importance (86%) of cognitive self-assessments. Public demand for cognitive self-assessment was confirmed by consumers who trialed myMemCheck® as part of their survey participation—86% agreed on the need for a tool like myMemCheck®. Mixed methods findings suggest that myMemCheck® could fast- track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in healthcare, and prevent negative outcomes associated with undetected cognitive impairment.

scholarly journals Memory-Related Frontal Brainwaves Predict Transition to Mild Cognitive Impairment in Healthy Older Individuals Five Years Before Diagnosis

2020 ◽  
pp. 1-11
Author(s):  
Yang Jiang ◽  
Juan Li ◽  
Frederick A. Schmitt ◽  
Gregory A. Jicha ◽  
Nancy B. Munro ◽  
...  
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Memory Performance ◽  
Memory Task ◽  
Cognitive Status ◽  
Older Individuals ◽  
Increased Risk ◽  
Differentiation Pattern

Background: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer’s disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals. Objective: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis. Methods: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, annual cognitive status, and longitudinal changes in memory recall scores up to 10 years were analyzed. Results: Seven of the 19 cognitively normal older adults were diagnosed with incident aMCI for a median 5.2 years later. The seven converters’ frontal brainwaves were statistically identical to those patients with diagnosed aMCI (n = 14) at baseline. Importantly, the converters’ baseline memory-related brainwaves (reduced mean frontal responses to memory targets) were significantly different from those who remained normal. Furthermore, differentiation pattern of left frontal memory-related responses (targets versus nontargets) was associated with an increased risk hazard of aMCI (HR = 1.47, 95% CI 1.03, 2.08). Conclusion: The memory-related neuromarkers detect MCI-like brain signatures about five years before diagnosis. The individualized frontal neuromarkers index increased MCI risk at baseline. These noninvasive neuromarkers during our Bluegrass memory task have great potential to be used repeatedly for individualized prognosis of MCI risk and progression before clinical diagnosis.

scholarly journals Refining sleep measurement using the Motionwatch8©: How many days of monitoring do we need to get reliable estimates of sleep quality for older adults with Mild Cognitive Impairment?

2020 ◽  
Author(s):  
Ryan S. Falck ◽  
Cindy K. Barha ◽  
Patrick C.Y. Chan ◽  
Teresa Liu-Ambrose
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sleep Duration ◽  
Older Adult ◽  
Cognitive Assessment ◽  
Cognitive Status ◽  
Field Methods ◽  
Sleep Measurement ◽  
Reliability Coefficients

Abstract Background Mild cognitive impairment (MCI) is a transition stage between healthy cognition and dementia, and is linked to poorer sleep. Objective, reliable, and low-burden field methods to measure older adult sleep are also currently needed. The MotionWatch8© (MW8) wrist-worn actigraph provides estimates of sleep with 14 days of observation; however, there may be underlying differences in the reliability of sleep estimates based on MCI status. We therefore investigated the number of MW8 monitoring days required to estimate sleep in older adults with MCI and without. Methods Older adults (55+ years; N=151) wore the MW8 for ≥14 days. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of <26/30) and participants without MCI (≥26/30). We calculated intra-class reliability coefficients for 1-, 7-, and 14-days of wear-time, and performed Spearman-Brown predictions to determine the number of monitoring days needed for an ICC=0.80. Results Older adults with MCI were older ( p <0.01), more likely to be male ( p =0.03), and had shorter sleep duration ( p <0.01). Spearman-Brown analyses indicated that the number of monitoring days needed for an ICC=0.80 in older adults with probable MCI was 7 days for sleep duration, 4 days for fragmentation, and 4 days for efficiency; adults without MCI required 4 days for duration, 6 days for fragmentation, and 3 days for efficiency. Conclusions Our results indicate that while the reliability of MW8 estimates of sleep differs based on cognitive status, 7 days of MW8 monitoring provides reliable estimates of sleep for adults with MCI and those without.

scholarly journals ATTITUDES AND PREFERENCES FOR ROBOT-LED PIANO COGNITIVE TRAINING: FEASIBILITY IN MILD COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S946-S946
Author(s):  
George Mois ◽  
Bailley Collette ◽  
Lisa M Renzi-Hammond ◽  
Laura Boccanfuso ◽  
Aditi Ramachandran ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Technology Acceptance ◽  
Cognitive Training ◽  
Neural Plasticity ◽  
Verbal Memory ◽  
Cognitive Status ◽  
Cognitive Domain ◽  
Assistive Robots

Abstract Cognitive training has been shown to improve neural plasticity, increase cognitive reserve and reduce the risk of dementia in older adults. Specifically, learning to play the piano has been shown to be an engaging, multimodal form of cognitive training. However, accessing this form of cognitive training can pose a challenge for older adults. Socially assistive robots present a unique opportunity to increase access to user-tailored piano learning cognitive training. The present study utilized a robot-led four-week piano lesson feasibility intervention for older adults with mild cognitive impairment (N = 11; M= 74.64 ± 6.02 years of age; 72.72% female; 90.1% White/Caucasian). Cognitive Status was assessed during screening via the Telephone Interview for Cognitive Status, and after screening via the Mini-Mental State Exam and the CNS Vital Signs computerized test suite to measure cognitive domain-specific functioning. Perceptions and acceptance of the robot were measured using the Robotic Social Attributes Scale (RoSAS) and Technology Acceptance Scale. Cognitive function improved after four weeks of training in the verbal memory, executive function, reaction time and cognitive flexibility domains, and in the computed neurocognitive index score (p&lt;0.05). Survey data and qualitative interviews show that participants perceived the robot instructor as socially engaging, competent, useful, and easy to use. These results provide insight into the potential of SARs to facilitate cognitive training in the form of piano lessons, as well as recommendations for creating a suitable robot instructor for this application.

scholarly journals Identifying the Factors Related to Depressive Symptoms Amongst Community-Dwelling Older Adults with Mild Cognitive Impairment

2019 ◽  
Vol 16 (18) ◽  
pp. 3449 ◽  
Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Increased Risk ◽  
Community Dwelling Older Adults

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.

scholarly journals Assessing and disclosing test results for ‘mild cognitive impairment’: the perspective of old age psychiatrists in Scotland

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Stina Saunders ◽  
Craig W. Ritchie ◽  
Tom C. Russ ◽  
Graciela Muniz-Terrera ◽  
Richard Milne
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Assessment Tool ◽  
Clinical History ◽  
Diagnostic Process ◽  
Test Results ◽  
Risk Disclosure ◽  
Therapy Assessment ◽  
The Individual

Abstract Background Mild cognitive impairment (MCI) is a condition that exists between normal healthy ageing and dementia with an uncertain aetiology and prognosis. This uncertainty creates a complex dynamic between the clinicians’ conception of MCI, what is communicated to the individual about their condition, and how the individual responds to the information conveyed to them. The aim of this study was to explore clinicians’ views around the assessment and communication of MCI in memory clinics. Method As part of a larger longitudinal study looking at patients’ adjustment to MCI disclosure, we interviewed Old Age Psychiatrists at the five participating sites across Scotland. The study obtained ethics approvals and the interviews (carried out between Nov 2020–Jan 2021) followed a semi-structured schedule focusing on [1] how likely clinicians are to use the term MCI with patients; [2] what tests clinicians rely on and how much utility they see in them; and [3] how clinicians communicate risk of progression to dementia. The interviews were voice recorded and were analysed using reflective thematic analysis. Results Initial results show that most clinicians interviewed (Total N = 19) considered MCI to have significant limitations as a diagnostic term. Nevertheless, most clinicians reported using the term MCI (n = 15/19). Clinical history was commonly described as the primary aid in the diagnostic process and also to rule out functional impairment (which was sometimes corroborated by Occupational Therapy assessment). All clinicians reported using the Addenbrooke’s Cognitive Examination-III as a primary assessment tool. Neuroimaging was frequently found to have minimal usefulness due to the neuroradiological reports being non-specific. Conclusion Our study revealed a mixture of approaches to assessing and disclosing test results for MCI. Some clinicians consider the condition as a separate entity among neurodegenerative disorders whereas others find the term unhelpful due to its uncertain prognosis. Clinicians report a lack of specific and sensitive assessment methods for identifying the aetiology of MCI in clinical practice. Our study demonstrates a broad range of views and therefore variability in MCI risk disclosure in memory assessment services which may impact the management of individuals with MCI.

scholarly journals Food Insecurity Is Associated with Mild Cognitive Impairment among Middle-Aged and Older Adults in South Africa: Findings from a Nationally Representative Survey

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 749 ◽  
Author(s):  
Ai Koyanagi ◽  
Nicola Veronese ◽  
Brendon Stubbs ◽  
Davy Vancampfort ◽  
Andrew Stickley ◽  
...  
Keyword(s):  
South Africa ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Food Insecurity ◽  
Longitudinal Research ◽  
World Health ◽  
Multivariable Logistic Regression Analysis ◽  
Adult Health ◽  
Cross Sectional

There are no studies on the association between food insecurity and mild cognitive impairment (MCI). Thus, cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in South Africa (2007–2008) were analyzed to assess this association. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted. The sample consisted of 3,672 individuals aged ≥50 years [mean (SD) age 61.4 (18.3); 56% females]. The prevalence of MCI was 8.5%, while 11.0% and 20.8% experienced moderate and severe food insecurity, respectively. After adjustment for potential confounders, moderate and severe food insecurity were associated with 2.82 (95%CI = 1.65–4.84) and 2.51 (95%CI = 1.63–3.87) times higher odds for MCI compared with no food insecurity, respectively. The OR for those aged ≥65 years with severe food insecurity was particularly high (OR = 3.87; 95%CI = 2.20–6.81). In conclusion, food insecurity was strongly associated with MCI among South African older adults. Future longitudinal research is required to assess whether addressing food insecurity may reduce risk of MCI and subsequent dementia.

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